For some providers, 2013 may have been the year of the electronic health record (EHR). Nearly $17 billion in Medicare incentive payments were made to hospitals and physicians to encourage adoption of the technology. Still, the growth in use has been slower than expected, and with the extension of Stage 2 meaningful use requirements, some providers remain skeptical about its chances for complete integration.

“Nearly every Institute of Medicine report or blue-ribbon panel tasked with developing ideas for fixing our healthcare delivery system points to the same solution: greater use of health information technology (HIT),” wrote Ashish K. Jha, MD, MPH, in The American Journal of Managed Care. He adds, “Despite more doctors and hospitals using these systems, the quality and efficiency gains that were widely expected have not been evident. While some advocates argued that simply implementing HIT would have dramatic effects on the care we provide, the evidence that has emerged is more sobering and more complex: HIT may be necessary for high-value healthcare, but it is not sufficient. This leaves us at a critical crossroads with a perplexing question: What else is required to ensure that the national investment in HIT pays off for clinicians, hospitals, and ultimately, the patients they serve?”

As well, some providers who were once eager for the adoption of EHR programs are now opting out. One reason is that incentive payments tied to the program were mainly for Stage 1 meaningful use, meaning that many do not see a financial benefit in continuing to participate. This is only further underlined by a belief that the cost and effort required to meet Stage 2 and Stage 3 meaningful use won’t translate into any sort of significant improvement in patient treatment outcomes.

“I’m going ahead as best I can, but I’m not sure I’m going to make it,” said Dr Scott Macleod, a private family practitioner based in Virginia. He suggests that the Stage 2 program has been “shoved too fast, too furious. ...I think you’re going to see a lot of dropouts.”

There is also the added challenge of transitioning to ICD-10, which makes meeting Stage 2 meaningful use all the more difficult for some providers.

“We’re tackling both, and we believe we’ll be ready, but we’re going to place a lot of stress on the physicians,” said Dr Grace Terrell, CEO of Cornerstone Health Care. “Our organization has put a lot of investment into HIT over the last few years to really move into population health management. We’re just in that God-awful stage right now to make it function.”

Physicians hope that the administration will reevaluate current timelines and penalties for meeting requirements for meaningful use in 2014. This consideration is important to ensure that patient safety and care quality is maintained.